Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans.Its common features include a burning painful sensation in the mouth,often associated with dysgeusia and xerostomia,...Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans.Its common features include a burning painful sensation in the mouth,often associated with dysgeusia and xerostomia,despite normal salivation.Classically, symptoms are better in the morning,worsen during the day and typically subside at night.Its etiology is largely multifactorial,and associated medical conditions may include gastrointestinal,urogenital,psychiatric,neurologic and metabolic disorders,as well as drug reactions.BMS has clear predisposition to peri-/post menopausal females.Its pathophysiology has not been fully elucidated and involves peripheral and central neuropathic pathways.Clinical diagnosis relies on careful history taking,physical examination and laboratory analysis.Treatment is often tedious and is aimed at correction of underlying medical conditions,supportive therapy,and behavioral feedback.Drug therapy with alpha lipoic acid,clonazepam,capsaicin,and antidepressants may provide symptom relief.Psychotherapy may be helpful.Short term follow up data is promising,however,long term prognosis with treatment is lacking.BMS remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment.展开更多
Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typica...Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient’s re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.展开更多
Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic gastroparesis.Clinically,patients present with early satiety,abdominal ful...Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic gastroparesis.Clinically,patients present with early satiety,abdominal fullness,nausea,epigastric discomfort and eructation.Permanent gastric retention of a video capsule endoscope is diagnostic in differentiating between the two diseases,in the absence of an organic gastric outlet obstruction.This case presents the longest video capsule retention in the medical literature to date.It is also the first case report of adult hypertrophic pyloric stenosis diagnosed with video capsule endoscopy or a computed tomography scan.Finally,an unusual"plugging"of the gastric outlet with free floating capsule has an augmented effect on disease physiology and on patient’s symptoms.展开更多
文摘Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans.Its common features include a burning painful sensation in the mouth,often associated with dysgeusia and xerostomia,despite normal salivation.Classically, symptoms are better in the morning,worsen during the day and typically subside at night.Its etiology is largely multifactorial,and associated medical conditions may include gastrointestinal,urogenital,psychiatric,neurologic and metabolic disorders,as well as drug reactions.BMS has clear predisposition to peri-/post menopausal females.Its pathophysiology has not been fully elucidated and involves peripheral and central neuropathic pathways.Clinical diagnosis relies on careful history taking,physical examination and laboratory analysis.Treatment is often tedious and is aimed at correction of underlying medical conditions,supportive therapy,and behavioral feedback.Drug therapy with alpha lipoic acid,clonazepam,capsaicin,and antidepressants may provide symptom relief.Psychotherapy may be helpful.Short term follow up data is promising,however,long term prognosis with treatment is lacking.BMS remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment.
文摘Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient’s re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.
文摘Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic gastroparesis.Clinically,patients present with early satiety,abdominal fullness,nausea,epigastric discomfort and eructation.Permanent gastric retention of a video capsule endoscope is diagnostic in differentiating between the two diseases,in the absence of an organic gastric outlet obstruction.This case presents the longest video capsule retention in the medical literature to date.It is also the first case report of adult hypertrophic pyloric stenosis diagnosed with video capsule endoscopy or a computed tomography scan.Finally,an unusual"plugging"of the gastric outlet with free floating capsule has an augmented effect on disease physiology and on patient’s symptoms.
